| NPI | 1215199476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: TX N3421) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N3421) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2024-03-20 |